One 36-year-old woman from Quebec with a family history of breast cancer developed the disease while having IVF treatment. Dr Laura Arbour, from the McGill University in Quebec, Canada has questioned whether the hormonal stimulation of IVF treatment might quicken the progression of cancer in those who are hereditarily disposed (The Lancet, Aug 27, 1994).

According to medical science, the cause of men's infertility usually remains unknown (N Engl J Med, Feb 2, 1995), although proponents of natural fertility methods such as Foresight, The Association of Preconceptual Care, would disagree.

The various forms of medical therapy that have been tried fall into two broad categories: those whose use is irrational and clearly not effective, and those that are unproved (N Engl J Med, Feb 2, 1995). Likewise, there appears to be little evidence regarding the risks involved.

Japanese research into the adverse effects of the drug interferon on the formation and development of sperm in rats found that some rats showed an increase in sperm count when treated with interferon. The researchers then administered interferon to three men with a history of a very low sperm count and one with no sperm. The cause of infertility in all four was unknown. All three of the men with very low sperm counts showed significant improvement in sperm count and motility after two months' therapy, and two impregnated their wives. The fourth man produced some sperm, but count and motility were very low. The Japanese researchers were ecstatic, believing their "promising" results would "pave the way" for a new infertility treatment (The Lancet, Aug 27, 1994).

But other research has suggested that interferon might have a harmful effect on testicular function, as impotence has been reported as a side effect. And what the researchers don't mention are the possible adverse reactions associated with interferon, which is used to treat certain cancers, chronic viral infections such as hepatitis B and C, and multiple sclerosis. Severe fever is common, and there may be lethargy, headaches, dizziness, depression, digestive disturbances and, rarely, hair loss. The blood-producing capacity of the bone marrow may be reduced, and some patients experience high or low blood pressure and heartbeat irregularities. Regular blood counts are essential during treatment, particularly to check on levels of white blood cells that contribute to the immune system.

Of course, for those desperate to have a child, the proven and possible risks associated with infertility treatment might seem worth it. However, the risk factors should be weighed up against the chances of success which are often cruelly inflated at individual clinics or by infertility specialists seeking to boost their reputations. It is estimated that only about 10 per cent of couples conceive on their first IVF attempt. In the UK, according to Human Fertilization and Embryology Authority figures, only 12.7 per cent of IVF treatments resulted in a live birth in 1992. This figure had fallen from 13.9 per cent in 1991, which the authority attributes to the fact that the average age of women seeking treatment has increased.

In contrast, Foresight, the Association for the Promotion of Preconception Care based in Surrey, England, boasts an 80 per cent success rate through its rigorous health and nutrition programme (see box, opposite). A study of 418 couples who had followed the Foresight programme was conducted at Surrey University. It found that of those who'd previously been infertile, 81 per cent delivered live babies, as did 81 per cent of those who'd had previous miscarriages and 73 per cent who'd had previous stillbirths. In the study group, no babies were born earlier than 36 weeks and none weighed less than 5lb 3oz. There were no miscarriages, perinatal deaths, malformations or babies requiring admission to special care. Of the 418 couples, 75 per cent had had either previous infertility or miscarriage (WDDTY, September 1994).

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